| NPI | 1982161006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO 205687) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 36075) |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2023-06-22 |